Before the procedure
Sticky patches called electrodes are placed on your chest to check your heartbeat. Your blood pressure also is checked. Your heart rate, pulse, blood pressure and oxygen level are continuously checked before, during and after the procedure.
A member of your healthcare team may shave any hair from the body area where a flexible tube called a catheter will be inserted.
During the procedure
Coronary angioplasty and stenting is usually done in the hospital in a room with special X-ray and imaging machines.
A healthcare professional inserts an IV into your arm or hand. You get medicines to help you relax. The amount of sedation needed for coronary angioplasty and stenting depends on your health conditions and why you're having the procedure. Usually you are awake during angioplasty. But some people may need a combinations of medicines that puts them to sleep during the procedure. This is called general anesthesia.
Fluids and other medicines, such as blood thinners, also are given through the IV.
The area where the catheter goes is numbed. Then, the doctor makes a small cut to reach the blood vessel. The catheter is inserted into the blood vessel and guided to the heart.
Dye flows through the catheter. The dye helps blood vessels show up more clearly on the X-ray images. Doing this helps the doctor check for blockages in the heart arteries. The results help your doctor decide whether to continue with the angioplasty.
Angioplasty and stent placement
Angioplasty is the process of opening an artery by inflating a balloon. A stent is a mesh coil that helps hold the artery open. Most stents slowly release a medicine that prevents the artery from re-narrowing.
During angioplasty and stenting, flexible tubes called catheters and a balloon are used to reopen a blocked artery. A catheter with an uninflated balloon on the tip is guided to the blocked artery. The balloon inflates, widening the artery. The balloon is deflated and removed. A stent is placed at the narrowed part to help keep the artery open.
If there's more than one blockage, the process may be repeated.
You might feel pressure in the area where the catheter is inserted. You also may feel some mild discomfort when the balloon is inflated.
Your healthcare team tells you how long the procedure is expected to take. The procedure and recovery typically takes several hours.
After the procedure
How long you stay in the hospital after angioplasty and stenting depends on why the procedure was done.
When you return home, rest and drink plenty of fluids to help remove the imaging dye from your body. You can expect the following after coronary angioplasty and stenting:
- Blood-thinning medicines. After getting a stent, you may need to take medicines to prevent blood clots. Your doctor may recommend taking aspirin with another medicine, such as clopidogrel (Plavix), ticagrelor (Brilinta) or prasugrel (Effient). Aspirin recommendations vary. Check with your healthcare team before starting aspirin.
- Activity restrictions. Do not do strenuous exercise or lift heavy objects for at least 24 hours after coronary angioplasty and stenting. Ask your healthcare team if you have any other activity restrictions.
- Cardiac rehabilitation. Your heart doctor may suggest a personalized program of exercise and education called cardiac rehabilitation. It typically involves exercise training, emotional support and education about a heart-healthy lifestyle. The supervised program is designed to improve health in those with heart disease. It's often recommended after a heart attack or heart surgery.
After coronary angioplasty and stenting, it's important to watch for complications. Call your healthcare provider's office or hospital staff immediately if you have:
- Chest pain or shortness of breath.
- Weakness or fainting.
- Bleeding or swelling at the body area where the catheter was placed.
- Pain or discomfort at or below the catheter site. For example, pain in the hand if the catheter went into a blood vessel in the arm.
- Signs of infection, such as redness, swelling, drainage or fever.
- A change in temperature or color of the leg or arm that was used for the procedure.
You will have follow-up appointments to check your heart health as you recover. During these checkups, blood and imaging tests may be done to see how well your heart is working.